Tess' Psychiatric Report
by oliviak8
Summary: A short psychiatrist report on how certain events affected Tess. Please read and comment on any improvements you think should be made :D


This is a psychiatric report written on Tess. I wrote this because I wanted to see how the different things that happened to her affected her.

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><p>PSYCHIATRIC REPORT<p>

On the case of TESS D'URBERVILLE

This patient was admitted due to symptoms of major depression witnessed by Alec d'Urberville.

My conclusions are based on the following evidence.

EVIDENCE EXAMINED

I have had psychiatric interviews with the following persons:

Tess D'Urberville

Alec D'Urberville

Joan Durbeyfield

SUMMARY OF THE CHIEF SYMPTOMS ON WHICH THE DIAGNOSIS OF PSYCHOPATHIC CHARACTER IS BASED:

An unchanging negativism of thought and action.

Constant feeling of guilt

Behavioural Self-Blame

Characterological self-blame

Dysthimia

Post-Traumatic Stress Disorder

Clinical Depression

Reactive Depression

Melancholia

Details of symptoms of depression in chronological order

Childhood  - from an early age Tess threw upon her shoulders the family burdens, especially when the family horse was killed. She therefore sacrificed herself to work with a man she barely knew in order to make up for what she had done. The psychodynamic view relating depression in adulthood to Tess's early relationship with her parent's shows she has quite hostile feelings towards them, and these are redirected towards herself in the form of self-accusation or self-hatred. These feelings arise from a lack of love, support and safety. Tess' parents made decisions for her and without her best intentions with the example of making her meet Alec d'Urberville without any knowledge of him.

Working with Alec d'Urberville – Tess spent several months working for a man who deceived her into believing she was his 'cousin'. This caused bitterness which led to depression and trust issues. During these months, Tess claims that Alec raped her. Tess has internalized that the rape is somehow her fault and should have anticipated it, especially as Tess recounts that he would say things such as '_Let me put one little kiss on those holmberry lips'_. She feels she could have prevented it if only she had fought harder. Tess knew her attacker, and so feels that she somehow provoked the rape. This has caused her to behavioural self-blame and to feel guilt.

Returning Home –One result of the assault was a feeling of being judged by society. Tess's acceptance of society's judgment and its stern religious views made her believe that she was an immoral woman. Her guilt at breaking society's conventions made her isolate herself. She gave birth to Alec's child and named him Sorrow. The name obviously connotes her great sadness and is likely to bring back memories of the attack. However Sorrow died soon after he was born. This subsequently led to a deep depression. Her mother reports that Tess was extremely drained physically and mentally. With the added depression of losing a child, this threw Tess into a state of shock. Tess shut down and blocked everything out. Tess' mourning period never ended and as a result continued in a state of permanent melancholia.

Working at the Dairy Farm – A sexual assault disturbs the survivor's normal routine and therefore Tess felt a strong need to get away and moved to Talbothays Dairy Farm. Here Tess returned to normalcy and happiness, even developing a relationship with Angel Clare. Tess ran into a man who used to work for Alec d'Urberville. This encounter with the man who recognizes her as 'Alec d'_Urberville's mistress' serves to reinforce the idea that _Tess is perpetually at the mercy of Alec and that he will forever haunt her throughout her life. This brought back memories, leading her back into a feeling of shame and guilt for not telling Angel what happened. Angel said he noticed Tess become quiet and withdrawn but just believed it was because the man had frightened her.__

Marriage to Angel – Angel admitted to Tess that he had an affair. Tess therefore confessed about the rape. This would have required considerable courage as recalling a sexual assault can be very traumatic for the victim may produce a feeling of embarrassment for some survivors. The fact that he couldn't forgive her brought back feelings of shame as Tess was mistakenly made to believe that she did something wrong and caused the rape, or that the rape has made her in some way bad and suspect.

Working at Flintcombe-Ash – Working here enforced Tess' to view that women have a poorer quality of life than men as they have lower paid/status jobs. She struggled and went in search of Angel's parents for help. She overheard Angel's brothers speaking of his poor marriage and left out of shame. As Survivors often seem to be blamed for the assault; it is not surprising that she would be fearful of social condemnations. There is a correlation between the onset of depression and the absence of social support. Thus, Tess was at risk from depression because of social isolation. She also ran into Alec d'Urberville, which made her re-experience the trauma. She admits to feeling anger as he was able to carry on with his life while she had to suffer. Tess felt abandoned when she told Alec she was already married but Angel wasn't there to protect her.

Being with Alec – Tess' father unexpectedly died, causing a psychodynamic state to return. They were evicted from their house which put stress and pressure on Tess to find somewhere to live. Alec offered to house the Durbeyfield's. Tess recalls Alec saying _"__Remember, my lady, I was your master once! I will be your master again."_ She isn't able to fully recover as she's constantly made to see her attacker. Being forced to take shelter in a churchyard, Tess clearly shows signs of severe depression after admitting to suicidal thoughts when she went to the D'urberville vault and asked _"Why am I on the wrong side of this door_?" After telling Tess that he will provide for her family, she accepted his proposal. Alec is clearly in control of their relationship, especially when she appears vulnerable.

Interview WithAlec d'Urberville

Alec d'Urberville exhibited no sense of remorse believing that Tess consented and that he did not 'rape' her. According to him, Tess encouraged him and that he would never hurt her because he loves her and that her 'husband' Angel is the one to blame for abandoning her. He believes that Tess should be thanking him for saving her family from poverty.

Psychiatric Conclusions

Tess d'Urberville has exhibited through her life, symptoms of Major Depression due to the traumatic event of being raped and has developed slowly as a consequence of numerous personal disappointments and life problems. I believe Tess has recurring depression and Dysthymia, although at present we have been unable to distinguish all of Tess' emotional feelings as she is very unwilling to talk.

Based on direct observations, Tess is traumatised and depressed after her attack. However, these natural responses are as competent as any citizen's reaction. Tess is very withdrawn and her body language barrier shaped the emotions and portrayed somatic symptoms of insecurity and loneliness. The whole picture is completely characteristic for Post-Traumatic Stress Syndrome as these symptoms have lasted more than one month and caused significant impairment in social, occupational and other important areas of functioning. This has overwhelmed Tess' ability to cope, making her rely on Alec more.

Currently, Tess d'Urberville appears to remain extremely paranoid. She lacks sufficient motivation to rely on external supports and lacks sufficient personal insight to cope independently.

It's recommended that efforts to establish a trusting relationship with this patient be continued, to help her cultivate a more adaptive coping/defensive pattern. Group interventions will be more productive than Individual therapy. Once her guardedness has been relaxed, it will likely be beneficial to explore psychosocial issues present at the time Tess d'Urberville was raped.

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><p>Please tell me how you think I could improve it. I'm not too sure on it myself, for example I'm not too keen on the subheadings but couldnt think of anything else. Hopefully it wasn't too bad<p> 


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